ROBERT WILLIAM TRACEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

WILLIAM

Last Name

TRACEY

Business Name

ROBERT WILLIAM TRACEY MD

Original Issue Date

01/09/2018

Effective Date

01/09/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021